The present invention pertains to an inexpensive, hand-held otoscope and a curette for use with the otoscope in examining small orifices in the body such as the ear canal. More particularly, the present invention pertains to both an otoscope having coupling means and a curette fabricated from a transluscent, non-abrasive, flexible material, which curette is equipped with corresponding coupling means for releasably coupling it with the otoscope. The otoscope includes a light source, such that once coupled to the otoscope, the curette transmits the light from the source into the orifice so that both an optical path and a view path are provided into the orifice to enable examination and treatment without discomfort to the patient.
Often it is desirable to inspect the ear drum and the ear canal for evidence of infection, or for bulging which indicates undue pressure from the inner ear, or simply for wax which may plug the ear. Likewise, infected debris which accumulates as during "swimmer's ear" need also be examined for subsequent removal. In children, foreign material such as cotton, tissue paper, or even small toy beads, for example, may be found to occlude the ear canal and thus necessitate removal.
Practitioners such as an ear, nose and throat (ENT) specialists routinely have specialized equipment such as binocular microscopes, head mirrors providing illumination, suction devices, irrigation, and other special devices at their disposal. Such devices are quite expensive, however, and may further require special skills for their use. Consequently, most school nurses, or nurses in other care facilities are prevented from using such devices. Even many pediatricians and family practitioners either do not have such devices at their disposal or are not experienced enough in their use.
Without the benefit of the specialized equipment commonly available to ENT specialists, school nurses or pediatricians etc. frequently have carried out examinations of the ear canal with prior art otoscopes. Then if occluding matter was found, the ear would be irrigated with warm water and hydrogen peroxide, for example, by means of a syringe or other irrigation device to dissolve or soften the occluding material to permit the removal thereof. Once the matter, such as wax, is softened by the irrigation fluid, it would often be removed manually with the aid of a metal curette. An example of such a curette is provided in U.S. Pat. No. 2,331,732 which discloses a plastic handle, a shank part embedded in the handle and a head portion connected to the shank. The head portion is bowed to better fit the ear and comprises an eye formed of stiff wire bent back upon itself.
Examinations carried out in the foregoing manner using metal curettes could easily result in the abrasion of the tissues of the ear, especially when those tissues are wetted and softened by the irrigation fluid. Occasionally, even perforation of the ear drum can result. The risks involved in performing these procedures with equipment known in the art are even further increased when examining and treating small children. As is all too well known, children will cooperate minimally, if at all, and are likely to become fearful and move about during the examination. Moreover, due to the noise and sensation of the curette within the ear, some children may develop vertigo and nausea during examination or treatment. Thus, these procedures are made quite complicated by the child's movements, and much time is required to complete the examination and the treatment.
The problems inherent in examining sensitive orifices of the body have been recognized, and improved otoscopes and other ear cleaning devices have resulted. For example, U.S. Pat. No. 4,572,180 discloses a lighted ear canal curette instrument including a hand-held lighting member, a curette having an elongated handle and retaining members which telescopically receive both the handle member and the curette to secure the curette thereto. A magnification lens is hingedly attached to the lighting member to provide a view path as well as an optical path into the ear canal. U.S. Pat. Nos. 1,556,510; 3,110,304; 3,592,199; and 4,566,439 disclose other instruments for viewing into the ear canal or the like. Another hand-held curette is typified by U.S. Pat. No. 1,737,106, wherein an ear curette having a tubular handle and a stiff, but flexible non-metallic loop which projects from one end thereof is provided. A band of soft fabric forming a wiping element is secured at the opposite end of the handle. Various other curettes and sampling devices are disclosed in U.S. Pat. Nos. 622,386; 1,533,123; 3,254,356; 3,626,946; 3,635,222; and 4,027,658.
To most assuredly avoid injuring the tissues of the ear, especially the ears of small children during the inspection and cleaning thereof, excellent visual access should be provided. Further, any probing within the ear canal should be performed with a flexible member to prevent abrasion. This is especially important when the canal is made wet and particularly sensitive due to the softening effects of irrigating solutions or the like. Finally, the probing member should be disposable so as to ensure against contamination.